I'm pretty new to this forum and this is my first post. I have SPMS and have been going thru the decision process w/my doctor on starting Tysabri.

I was previously on Gilenya for 4 years and on Rebif for 2 years prior. I am "marginally" JC Virus postive (.59). With hubby of 30 years, made the gut wrenching decision to go forward even with the PML risk since I've been progressing steadily but slowly since the beginning. It does appear that the velocity of my progression has increased. I'm now a EDSS 6.5, have just retired and been approved for SS Disability.

Initially my insurance denied Tysabri since I'm JCV+. My neuro practice was able to lobby for a policy change with BCBSM and I'm now approved.

In the interim we started researching and talking with my neuro about doing pulse therapy with steroids instead. I'm wondering why I wouldn't start with pulse therapy given the nasty PML risk.

QUESTION: Any thoughts as to why I wouldn't do pulse therapy with steroids (Methylprednisone) first before starting on Tysabri?

I cannot say it will have an effect in SPMS but I would suspect that it might. The good news is there is a drug that is very similar on the market that many MSers are taking off label. Below is a good article about the drug.